Changes Of Levels Of Leukotriene B4 In Peripheral Blood Of Children With Henoch-schonlein Purpura And The Effect Of Montelukast On Its Treatment

Part ? Changes of levels of leukotriene B4 in peripheral blood of children with Henoch-Schonlein purpuraObjective To investigate the expression and its clinical significance of leukotriene B4(LTB4)and interleukin-33(IL-33)serum levels of children with henoch-schonlein purpura(HSP).Methods Thirty-five children with HSP and twenty healthy children were collected and preserved by centrifugation,While collecting laboratory indicators of inpatient children such as C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),immunoglobulin A(Ig A),immunoglobulin G(Ig G)and immunoglobulin M(Ig M).The serum levels of LTB4 and IL-33 were measured by enzyme-linked immunosorbent assay(ELISA),and analyzed the correlation between LTB4 and IL-33 and above laboratory indexes.Results The serum levels of LTB4 and IL-33 concentration in HSP were statistically higher than those in convalescent and healthy controls [LTB4: HSP group vs healthy control group(313.32�55.45)pg/ml vs(149.91�40.89)pg/ml,P < 0.05;IL-33: HSP group vs healthy control group(34.44 � 9.38)pg/ml vs(14.46 � 3.02)pg/ml,P < 0.05].The serum levels of LTB4 was positively correlated with CRP and had no significant correlation with ESR,Ig A,Ig M and Ig G;The serum levels of IL-33 was positively correlated with Ig A and CRP,and had no significant correlation with ESR,Ig M and Ig G.Conclusion LTB4 and IL-33 may play an important role in the pathogenesis of HSP.The incidence of IL-33 in HSP may be related to the increase of Ig A.Part ?The effect of montelukast in the treatment of henoch-schonlein purpuraObjective This study was designed to investigate the efficacy of montelukast in the treatment of HSP.Methods Thirty-five children with HSP according to the application of montelukast is divided into control group and conventional MK group,and collected these children's serum before and after treatment.The contents of LTB4 and IL-33 in serum were measured by ELISA,and analyzed changes before and after treatment.The changes and trend of serum LTB4 in the control group and the MK group were analyzed.The time of rash subsidence,joint symptoms(joint swelling and pain,limited activity),gastrointestinal symptoms(abdominal pain,fecal occult blood),renal damage(hematuria and proteinuria)to reduce or alleviate the situation were recorded in the treatment group and the control group;at the same time,two cases of hospitalized children within 3 months of recurrence of rash,a comparative analysis.Results Serum levels of LTB4 and IL-33 concentration after treatment were statistically lower than those in before treatment of HSP [LTB4: HSP after treatment(249.43�48.54)pg/ml vs HSP before treatment(313.32�55.45)pg/ml,P < 0.05;HSP after treatment(17.68�2.37)pg/ml vs HSP before treatment(34.44 � 9.38)pg/ml,P < 0.05].The level of serum LTB4(230.65�35.57)pg/ml in the MK group was significantly lower than that in the control group(281.21�52.16)pg/ml,the difference was statistically significant(P<0.05);The rash recurrence in MK treatment group than the control group decreased and the difference was statistically significant(P < 0.05);The average time of the rash subsided in the routine MK group(5.22�0.26)d was shorten than conventional treatment group(6.15�0.34)d,and there was significant difference between the two groups(P<0.05).Conclusion Montelukast can decrease the level of serum LTB4 in children with HSP.The effect of montelukast on oral treatment of HSP has a certain effect on shortening the time of rash subsets and reducing the recurrence of rash.